I think that tip refinement through a closed approach would produce the most reasonable change with a natural result.
Kenneth Hughes, MD
Los Angeles, CA
The rhinoplasty procedure can lengthen the nose, but this can be quite difficult because of the extensive cartilage grafting techniques that are necessary. Adding cartilage grafts to the nose we will make the nose longer, but will add bulk and width to the nose which may be counterproductive. Narrowing the tip is accomplished with a tip rhinoplasty which includes suture techniques applied to the lower lateral cartilages, and sometimes a conservative cartilage removal as well. Osteotomies of the nasal bones will narrow the bridge line. For many examples, please see the link below
Thank you for the photos but I would go on consults seeing specialists who will take your photo digitally and then alter it digitally with your input till you see the result you are looking for . That way you will be fully informed as to what can and cannot be accomplished and the surgeon will know exactly what changes you are looking for
Rhinoplasty is a personal decision. Your request to lengthen the nose and refine the tip are very doable. The uniqueness of the nose is as unique as the individual. The goal of the operation is not to replicate someone else’s nose, rather it is to provide balance with the rest of the face and improve function. Skin type, ethnicity, and age are all important factors when discussing nasal surgery. Following a consultation, a joint decision will be made based on your desires, any functional concerns, patient photographs, and realistic expectations.
Minimal natural refinement of bulbous wide nose is what you need done by an experienced rhinoplasty surgeon who does natural noses.
There are a variety of ways to improve the cosmetic appearance of a nose depending on individual anatomy and desired outcome.
It is important to keep in mind that following the exact advice from a surgeon on this or any other website who proposes to tell you what to do based on limited 2 dimensional photos and without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. The surgeon should have extensive experience in performing nasal surgery. You should discuss your concerns with that surgeon in person.
Robert Singer, M.D., FACS